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Indian Journal of Dermatology
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E-IJD QUIZ
Year : 2015  |  Volume : 60  |  Issue : 3  |  Page : 325
Foul smelling discharging tumor-like lesions in an immune-compromised adult female


1 Department of DVL, Muzaffarnagar Medical College and Hospital, Uttar Pradesh, India
2 Department of Pathology, Muzaffarnagar Medical College and Hospital, Uttar Pradesh, India

Date of Web Publication6-May-2015

Correspondence Address:
Tarang Goyal
Muzaffarnagar Medical College and Hospital, Muzaffarnagar, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.156494

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How to cite this article:
Goyal T, Varshney A. Foul smelling discharging tumor-like lesions in an immune-compromised adult female. Indian J Dermatol 2015;60:325

How to cite this URL:
Goyal T, Varshney A. Foul smelling discharging tumor-like lesions in an immune-compromised adult female. Indian J Dermatol [serial online] 2015 [cited 2021 Jul 26];60:325. Available from: https://www.e-ijd.org/text.asp?2015/60/3/325/156494



   Case Top


A 39-year-old female presented with foul smelling, variously sized, painless, large, asymptomatic tumor-like lesions on neck, chest, back, vulva, thighs, buttocks and lower legs since last 6-7 months. The lesions started as pea sized papules, gradually enlarged in size with subsequent foul smelling discharge [Figure 1]a and b.
Figure 1: (a) Variously sized, large, flesh colored, coalescing tumor-like giant lesions on lower back and posterior thigh region. (b) Large nodular skin colored lesions in the vulval region of the patient

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She had pallor but no icterus, clubbing, cyanosis or wasting were seen. There was no hepato-splenomegaly. Local examination revealed multiple, discreet, sessile, verrucous, skin-colored, discharging papulo-nodular coalescing lesions on the above sites. On pressing the lesions, extremely foul smelling whitish cheesy material was seen oozing from them [Figure 2]a and b]. The microscopic examination of caseous cheesy material showed homogeneous inclusion bodies within the keratinocytes.
Figure 2: (a) Giant lesions on gluteal area. (b) Milky white fluid oozing from lesions by slightly pressing the lesions

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The biopsy was done and histopathology picture is as below [Figure 3] showing hyperplastic epidermis with cells showing intracytoplasmic inclusions.

She was diagnosed to be HIV positive by ELISA method with CD4+ count to be 67 cells/mm 3 .
Figure 3: Histopathology picture showing lobules of keratinocytes with epidermal hyperplasia and large eosinophilic intracytoplasmic inclusion bodies (H and E, original magnification ×20). Inset shows close up of inclusion bodies (H and E, original magnification ×100)

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Question

What is your diagnosis?



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   References Top

1.
Reichert CM, O'Leary TJ, Levens DL, Simrell CR, Macher AM. Autopsy pathology in the acquired immune deficiency syndrome. Am J Pathol 1983;112:357-82.  Back to cited text no. 1
[PUBMED]    
2.
Brown J, Janniger CK, Schwartz RA, Silverberg NB. Childhood molluscum contagiosum. Int J Dermatol 2006;45:93-9.  Back to cited text no. 2
    
3.
Bateman F. Molluscum contagiosum. In: Shelley WB, Crissey JT, editors. Classics in dermatology. Springfield (IL): Charles C Thomas Publisher; 1953. p. 20.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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